加味芪榔方治疗药物依赖性气阴两虚型便秘患者的疗效及对外周血MTL,VIP,5-HT和5-HT4R的影响  

Clinical Efficacy of Modified Qilang Prescription in Treatment of Drug-dependent Constipation with Qi and Yin Deficiency and Its Effect on MTL,VIP,5-HT,and 5-HT4R in Peripheral Blood

作　　者：师哲 周蒙恩 张克慧 曹梦醒 李勇[1] SHI Zhe;ZHOU Meng-en;ZHANG Ke-hui;CAO Meng-xing;LI Yong(Shanghai Municipal Hospital of Traditional Chinese Medicine(TCM),Shanghai University of TCM,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《中国实验方剂学杂志》2021年第15期51-56,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：上海市科学技术委员会科研计划项目(18401904000)。

摘　　要：目的:探究加味芪榔方对药物依赖性气阴两虚型便秘患者的临床疗效及对血清血管活性肠肽(VIP),胃动素(MTL),5-羟色胺(5-HT),5-羟色胺4受体(5-HT4R)的影响。方法:选取符合药物依赖性气阴两虚型便秘诊断标准的患者160例,随机分为观察组与对照组,每组80例;观察组予加味芪榔方治疗,对照组予乳果糖口服溶液治疗,连续治疗8周。观察2组患者临床疗效,中医证候及血清VIP,MTL,5-HT,5-HT4R水平变化。比较2组临床疗效并进行至少8周复发率、中医证候随访。结果:观察组患者治疗后总有效率90.91%,对照组75.00%,观察组明显高于对照组(Z=-6.514,P<0.05)。2组患者治疗前血清VIP,MTL,5-HT,5-HT4R差异无统计学意义。连续用药8周后,2组患者血清VIP水平较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);2组患者血清MTL水平均较治疗前升高(P<0.05),且观察组明显高于对照组(P<0.05);治疗后观察组5-HT水平明显高于对照组(P<0.05);观察组5-HT4R水平较治疗前略有升高(P<0.05),但2组患者治疗后5-HT4R水平差异无统计学意义。随访至少8周,第2,4周观察组复发率明显低于对照组(P<0.05),第8周后观察组复发率57.14%(40/70),对照组复发率64.81%(35/54),差异无统计学意义。结论:加味芪榔方治疗药物依赖性气阴两虚型便秘临床近、中期疗效优于乳果糖,远期疗效不显著,其治疗机制或与调节患者血清VIP,MTL,5-HT水平有关。Objective: To investigate the curative efficacy of modified Qilang prescription on drugdependent constipation with Qi and Yin deficiency and the effects on serum vasoactive intestinal peptide(VIP),motilin(MTL),5-hydroxytryptamine(5-HT),and 5-hydroxytryptamine 4 receptor(5-HT4 R). Method: A total of 160 patients diagnosed with drug-dependent constipation were randomly divided into a treatment group(n=80,Qilang prescription)and a control group(n=80,lactulose oral solution). The treatment lasted for eight weeks. Changes in clinical symptoms,traditional Chinese medicine(TCM)syndrome,and serum VIP,MTL,5-HT,and 5-HT4 R before and after treatment were observed. The clinical efficacies of the two groups were compared. An eight-week follow-up was carried out for the observation of recurrent rate and TCM syndrome.Result:The overall response rate of the treatment group(90.91%)was higher than that(75.00%)of the control group(Z=-6.514,P<0.05). There was no significant difference in serum VIP,MTL,5-HT,and 5-HT4 R between the two groups before treatment. After treatment for eight weeks,both groups showed reduced serum VIP level as compared with those before treatment,and the treatment group was inferior to the control group(P<0.05). The serum MTL levels of the two groups were both higher than those before treatment(P<0.05),and the treatment group was superior to the control group(P<0.05). After treatment,the level of 5-HT in the treatment group was higher than that in the control group(P<0.05). The post-treatment 5-HT4 R level in the treatment group slightly increased(P<0.05),but no significant difference in 5-HT4 R levels between the two groups after treatment was observed. During the eight-week follow-up,the recurrence rate in the treatment group was significantly lower than that in the control group at the 2 nd and 4 th weeks(P<0.05). There was no significant difference in the recurrence rate between the treatment group[57.14%(40/70)]and the control group[64.81%(35/54)]after eight weeks. Conclusion:Modified Qilang prescripti

关 键 词：加味芪榔方 乳果糖 药物依赖性便秘 中药疗法 血管活性肠肽(VIP) 胃动素(MTL) 5-羟色胺(5-HT) 5-羟色胺4受体(5-HT4R) 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]